INTRODUCTION: The National Institute of Health and Care Excellence (NICE) has defined the terms, 'acute coronavirus disease 2019' (COVID-19), 'ongoing symptomatic COVID-19' and 'post-COVID-19 syndrome', with the latter two described as having persistent symptoms after the onset of COVID-19 symptoms for 4-12 weeks and >12 weeks, respectively. Persistent symptoms can either be due to the after-effects of COVID-19 or new-onset diseases after acute COVID-19. All symptoms observed beyond 4 weeks after the onset of COVID-19 need not be present at the time of onset. Previous studies on persistent post-COVID-19 symptoms have not mentioned new-onset diseases after acute COVID-19, and only a select few studies have discussed such new-onset symptoms. METHODS: Ninety-five patients who attended the post-COVID-19 clinic completed the requisite follow-up till 16 weeks after COVID-19 symptom onset. Data was recorded on a predesigned proforma. Necessary investigations were conducted to rule out any other cause of persistent symptoms. RESULTS: Fatigue (62.1%), breathlessness (50.5%) and cough (27.4%) were the most common symptoms present beyond 4 weeks after the onset of COVID-19 symptoms. Forty-nine (51.57%) patients developed post-COVID-19 syndrome - their severity of symptoms (odds ratio [OR] 17.77) and longer duration of hospital stay (OR 1.095) during acute disease were significantly associated with the development of post-COVID-19 syndrome. During follow-up, 25 patients developed new-onset symptoms, such as diabetes mellitus, hypertension and idiopathic tachycardia. CONCLUSION Patients can have persistent symptoms, new-onset symptoms and new-onset diseases after recovery from acute COVID-19.
Humans ; COVID-19/diagnosis* ; Female ; Male ; Prospective Studies ; Middle Aged ; Adult ; Fatigue/etiology* ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Aged ; Cough/etiology* ; Dyspnea/etiology*

CLINICAL PROFILE OF HOSPITALISED IRRITABLE BOWEL SYNDROME PATIENTS IN INDIA ntroduction: Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal disorder. However due to poor health-seeking behaviour of the people and difficulties faced by medical professionals to diagnose IBS, it remains an under-diagnosed gastrointestinal disorder. Objectives: To study the risk factors, clinical presentation, and management of IBS among in-patients admitted at two tertiary care hospitals in Mangalore. Methods: Forty-one patients diagnosed with IBS based on ROME IV criteria between January 2017 to March 2021 were included. A semi-structured proforma was used to collect the required information. Results: The mean age at diagnosis among the patients was 44.6 ± 17.8 years. Twenty-four (58.5%) of them were females. Family history of IBS was present among five (12.2%) patients. IBS-M [18 (43.9%)] was the most common type. Alarming signs like blood and mucus in the stools were present each among eight (19.5%) patients. Weight loss was the most common extra-intestinal symptom [nine (21.9%)]. Mental health problems and psychosomatic disorders were present among seven (17.1%) and six (14.6%) patients, respectively. The most common drug used to treat constipation was Ispaghula husk [17 (41.5%)], and to treat diarrhoea was Loperamide [14 (34.1%)]. As many as 15 (36.6%) patients did not improve with treatment. None of the patients were put on non-pharmacological therapies. Conclusion: Holistic management of alarming signs such as blood and mucus in the stools and extra-intestinal symptoms like weight loss is required among IBS patients. Various mental health problems and psychosomatic disorders need to be screened and treated as a part of its management. Non-pharmacological therapies need to be also introduced to improve its treatment outcomes.

BACKGROUND: Iron deficiency anemia is the most common form of anemia in India. Hemoglobin A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. However, reports on the effects of iron deficiency anemia on HbA1c levels are inconsistent. We conducted a study to analyze the effects of iron deficiency anemia on HbA1c levels and to assess whether treatment of iron deficiency anemia affects HbA1c levels. METHODS: Fifty patients confirmed to have iron deficiency anemia were enrolled in this study. HbA1c and absolute HbA1c levels were measured both at baseline and at 2 months after treatment, and these values were compared with those in the control population. RESULTS: The mean baseline HbA1c level in anemic patients (4.6%) was significantly lower than that in the control group (5.5%, p<0.05). A significant increase was observed in the patients' absolute HbA1c levels at 2 months after treatment (0.29 g/dL vs. 0.73 g/dL, p<0.01). There was a significant difference between the baseline values of patients and controls (0.29 g/dL vs. 0.74 g/dL, p<0.01). CONCLUSIONS: In contrast to the observations of previous studies, ours showed that HbA1c levels and absolute HbA1c levels increased with treatment of iron deficiency anemia. This could be attributable to nutritional deficiency and/or certain unknown variables. Further studies are warranted.
Adolescent ; Adult ; Anemia, Iron-Deficiency/*blood/drug therapy ; Child ; Female ; Ferritins/blood ; Hemoglobin A, Glycosylated/*analysis ; Hemoglobins/analysis ; Humans ; Iron/therapeutic use ; Male ; Time Factors

Glycated haemoglobins are haemoglobins with an attached sugar moiety. They constitute the HbA1 fraction of the adult haemoglobin HbA. HbA1c is the predominant fraction of HbA1 and gives an estimate of the blood sugar levels of an individual over the last three months. It has been observed that an HbA1c value of less than seven percent reduces the microvascular complications in diabetic patients. However, HbA1c is not affected by blood sugar levels alone. Apart from blood sugar, there are other factors that affect HbA1c. This article reviews in detail the structure, formation, methods of measurement, factors affecting HbA1c levels and their clinical significance.
Blood Glucose ; metabolism ; Diabetes Mellitus ; metabolism ; physiopathology ; Glycated Hemoglobin A ; analysis ; metabolism ; Humans